Allergic rhinitis among the elderly poses a particularly difficult diagnostic challenge for the otolaryngologist. As people age, they undergo immunosenescence. The thymus, which produces T cells against new invaders, atrophies markedly after adolescence, and this decline results in a less robust immune response to bacteria, viruses and presumably allergens (J Pathol. 2007;211(2):144-156). Consequently, physicians have assumed that allergies should decline as people age.
Explore this issue:October 2010
But this may be an oversimplification, according to Karen Calhoun, MD, professor of otolaryngology at Ohio State University and president of the American Society of Geriatric Otolaryngology. One problem is that testing for allergies among older patients becomes less reliable due to immunosenescence.
“The skin becomes less reactive,” said Dr. Calhoun, co-editor of Expert Guide to Otolaryngology (American College of Physicians, 2001). “The typical prick test is done on the very outer level of the epidermis, and as people age, they have fewer and fewer reactive cells in that layer, but you can detect allergies with intradermal testing, which is done at a deeper layer where there are more reactive cells in everyone. The big message is: Allergies do happen in older adults.”| | | Next → | Single Page